COVID-19 vaccination prevented an estimated 19.8 million deaths worldwide by December 2021, and remains our most important defence against severe disease and death from SARS-CoV-2, the virus that causes COVID-19. Getting vaccinated and staying up to date with recommended booster doses is the most important action we can take to protect ourselves and our family and friends during the pandemic.
But the time for mandating two-dose vaccination for COVID-19 in settings like universities is coming to an end. As experts in public health, health policy, epidemiology, workplace health and safety and bioethics, we have recommended La Trobe University begins preparing to remove its requirement for staff, students, contractors and visitors to be vaccinated when attending La Trobe’s campuses.
Vaccine mandates played an important role in increasing the vaccination rate in Australia and preventing the large-scale loss of life seen in many other countries. Mandatory vaccination in workplace settings also enabled employers to protect the health of their workers by reducing transmission of the virus. La Trobe was the first Australian university to announce that it would require people to be vaccinated to attend its campuses. As public health experts, we supported this decision.
At that time, the Delta variant of SARS-CoV-2 was circulating in Australia, and two doses of a COVID-19 vaccine provided strong protection against infection and transmission as well as excellent protection against severe disease, hospitalisation and death. There was a sound public health and workplace health and safety rationale underpinning La Trobe’s decision.
However, the situation is now very different. The Omicron variant currently circulating in Australia is far more infectious than Delta, and two doses of a COVID-19 vaccine are not as effective at preventing people from getting infected and spreading the virus to others. While booster doses increase vaccine effectiveness, boosters are not mandatory for most people and uptake has not been ideal to date. The effectiveness of vaccines in preventing infection and transmission has also been shown to wane within 20 weeks after the second and subsequent doses, and reinfection with Omicron is common.
What all of this means is that while vaccination remains very important in protecting us from severe illness, hospitalisation and death, vaccines alone cannot prevent infection, and mandates are therefore no longer necessary.
Vaccination mandates infringe on individual liberty and autonomy, and, according to the World Health Organization, they should only be used when necessary, and when there is no less intrusive means available to achieve the same outcome. They can also have significant unintended consequences, such as stigmatising unvaccinated people. If other more effective strategies are available to reduce the risk of transmission (for example, mask-wearing), these should be adopted instead.
Australia is now entering another wave of COVID-19 due to increasing circulation of the highly infectious Omicron sub-variants BA.4 and BA.5, along with increased mixing of people indoors during winter. As an employer, La Trobe University has an obligation to eliminate or reduce hazards as far as possible, using a range of control measures to reduce risks.
After careful consideration of the evidence, we have recommended that La Trobe University move towards removing its two-dose vaccination mandate and implementing a suite of effective strategies to reduce COVID-19 transmission on campus. Effective strategies include, among others, supporting the widespread use of high-quality N95 or P2 face masks; requiring household close contacts to work or study from home during the 7-day close contact period (given high transmission rates in households); and ensuring effective ventilation in University buildings.
Deborah Gleeson, Associate Professor in Public Health, Department of Public Health. Relevant expertise: Health policy
Rwth Stuckey, Associate Professor, Department of Public Health. Relevant expertise: Workplace health and safety